142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

307086
Resource and Support Systems for Community Health Workers Increases Demand for Quality Services and Community Participation in Uttarakhand

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 12:54 PM - 1:06 PM

Himani Sethi, Senior Program Specialist , Futures Group International, Gurgaon, India
Bhupinder Aulakh, Dr , Futures Group, Gurgaon, India
Nidhi Chaudhary, Dr , Team Leader, Futures Group, Gurgaon, India
Heer Chokshi, Ms , Communication and Program Development, Futures Group International India, Gurgaon, India
Background: India’s National Rural Health Mission (2005) introduced accredited social health activists (ASHAs), CHWs receiving performance-based remuneration, as an interface between the community and the public-health system. Uttarakhand, with hilly terrain, scattered settlements and poor road connectivity adversely affected ASHAs’ reach and potential remuneration. Methods: Under USAID Innovations in FP Services Project (2005-2012), FuturesGroup provided technical assistance to the State of Uttarakhand to design a pilot to improve selection, training, mentoring, and systems for ASHAs.  Under “ASHA Plus,” ASHAs covered flexible populations, were reimbursed for a wider range of services, trained in micro-planning tools and management information systems (MIS), had job-aids and tools for record keeping. State ASHA Resource Centre, State ASHA Mentoring Group, and District ASHA Resource Centres were establsihed. Results: Comparison of baseline(2006) and 2007-08 MIS data indicated improved services: 3 ANC visits (30% to 59%); preganncy registration (35% to 49%); institutional births (27% to 58%). Community-level outcomes: better outreach to underserved areas, awareness and demand of health schemes, and community monitoring; at the systems level, increased linkages service delivery points, record keeping, and interaction with other health cadres. In 2009, the government scaled up coverage in six districts (0.26 to 3.13 million people). In 2010, it expanded the supervisory system, the remuneration package, and established ASHA resource system statewide. Conclusions: Minor policy and systemic changes to suit local context, and strengthening capacities of CHWs can improve service uptake, accelerate improved health outcomes, and increase social participation and monitoring, with equitable service delivery leading to empowered communities.

Learning Areas:

Administration, management, leadership
Assessment of individual and community needs for health education
Program planning
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Identify policy and systemic changes that can strengthen capacities of community level health workers to accelerate improved health outcomes

Keyword(s): Health Systems Transformation, Hospitals

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a medical doctor with over 15 years experience in the field of public health, managing large and small projects, providing technical assistance to governments and institutions like the WHO in maternal, child, adolescent health and family planning.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.